Answers are grounded in this paper and cite their sources.
Editorials15 September 1990Practicing Health Promotion: The Doctor's DilemmaMarshall H. Becker, PhD, MPH, Nancy K. Janz, PhD, MSMarshall H. Becker, PhD, MPHSearch for more papers by this author, Nancy K. Janz, PhD, MSSearch for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-113-6-419 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptWhy have physicians been slow to integrate disease prevention and health promotion into routine clinical practice? Despite published guidelines, professional exhortations, and patient expectations, many physicians devote insufficient attention to implementing available prevention technologies and educating patients about modification of behavioral risk factors (1-6). The lost potential for health enhancement and disease prevention is considerable: Many persons visit a physician at least once in any given year; in surveys, physicians are cited by the public as the best and most reliable and credible source of health information; and much research has documented physician effectiveness (with minimal time and effort expenditure)...References1. JohnsHovellGaniatsPeddecordAgras MMTKW. Primary care and health promotion: a model for preventive medicine. Am J Prev Med. 1987;3:346-57. CrossrefMedlineGoogle Scholar2. WechslerLevineIdelsonPohmanTaylor HSRMJ. The physician's role in health promotion—a survey of primary care practitioners. N Engl J Med. 1983;308:97-100. CrossrefMedlineGoogle Scholar3. AndaRemingtonSienkoDavis RPDR. Are physicians advising smokers to quit? The patient's perspective. JAMA. 1987;257:1916-9. CrossrefMedlineGoogle Scholar4. RommFletcherHulka FSB. The periodic health examination: comparison of recommendations and internists' performance. South Med J. 1981;74:265-71. CrossrefMedlineGoogle Scholar5. WellsLewisLeakeSchleiterBrook KCBMR. The practices of general and subspecialty internists in counseling about smoking and exercise. Am J Public Health. 1986;76:1009-13. CrossrefMedlineGoogle Scholar6. WooWooCookWeisbergGoldman BBEML. Screening procedures in the asymptomatic adult: comparison of physicians' recommendations, patients' desires, published guidelines, and actual practice. JAMA. 1985;254:1480-4. CrossrefMedlineGoogle Scholar7. WeinbergAndrus AP. Continuing medical education: does it address prevention? J Community Health. 1982;7:211-4. CrossrefMedlineGoogle Scholar8. Ockene J. Smoking intervention: the expanding role of the physician. Am J Public Health. 1987;77:782-3. CrossrefMedlineGoogle Scholar9. McDill M. Structure of social systems determining attitude, knowledge and behavior toward disease. In: Enelow AJ, Henerson JB, eds. Applying Behavioral Science to Cardiovascular Risk, proceedings of a conference. Seattle, Washington. New York: American Heart Association; 1974:25-6. Google Scholar10. JanzBeckerKirschtErakerBilliWoolliscroft NMJSJJ. Evaluation of a minimal-contact smoking cessation intervention in an outpatient setting. Am J Public Health. 1987;77:805-9. CrossrefMedlineGoogle Scholar11. DemakBecker MM. The doctor-patient relationship and counseling for preventive care. Patient Educ Couns. 1987;9:5-24. CrossrefMedlineGoogle Scholar12. BeckerMaiman ML. Strategies for enhancing patient compliance. J Community Health. 1980;6:113-35. CrossrefMedlineGoogle Scholar13. CarterBelcherInui WDT. Implementing preventive care in clinical practice: problems for managers, clinicians, and patients. Med Care. 1981;38:195-216. CrossrefGoogle Scholar14. Relman A. Encouraging the practice of preventive medicine and health promotion. Public Health Rep. 1982;97:216-9. MedlineGoogle Scholar15. Taylor B. Preventive medicine in general practice. Br J Med. 1982;284:921-2. CrossrefMedlineGoogle Scholar16. WeinbergerMazzucaCohenMcDonald MSSC. Physicians' ratings of information sources about their preventive medicine decisions. Prev Med. 1982;11:717-23. CrossrefMedlineGoogle Scholar17. Neuhauser D. Don't teach preventive medicine: a contrary view. Public Health Rep. 1982;97:220-2. MedlineGoogle Scholar18. Yankauer A. The ups and downs of prevention. Am J Public Health. 1981;71:6-8. CrossrefMedlineGoogle Scholar19. CummingsGiovinoSciandraKoenigsbergEmont KGRMS. Physician advice to quit smoking: who gets it and who doesn't. Am J Prev Med. 1987;3:69-75. CrossrefMedlineGoogle Scholar20. Becker M. The tyranny of health promotion. Public Health Rev. 1986;14:15-25. MedlineGoogle Scholar21. Orlandi M. Promoting health and preventing disease in health care settings: an analysis of barriers. Prev Med. 1987;16:119-30. CrossrefMedlineGoogle Scholar22. InuiBelcherCarter TDW. Implementing preventive care in clinical practice: organizational issues and strategies. Med Care. 1981;38:129-54. CrossrefGoogle Scholar23. SegallBarkerCobbJacksonCarey AJSGJ. A general model for preventive intervention in clinical practice. J Med Educ. 1981;56:324-33. MedlineGoogle Scholar24. WellsLewis KC. The relations of physicians' personal health habits and attitudes to patient counseling [Abstract]. Clin Res. 1981;29:327A. Google Scholar25. ValenteSobalMuncieLevineAntlitz CJHDA. Health promotion: physicians' beliefs, attitudes, and practices. Am J Prev Med. 1986;2:82-8. CrossrefMedlineGoogle Scholar26. OrleansGeorgeHouptBrodie CLJK. Health promotion in primary care: a survey of U.S. family practitioners. Prev Med. 1985;14:636-47. CrossrefMedlineGoogle Scholar27. FarquharKing JA. Health promotion in health care settings. In: Prospects for a Healthier America: Achieving the Nation's Health Objectives. Washington, DC: U.S. Government Printing Office; 1984:21-39. Google Scholar28. Nutting P. Health promotion in primary medical care: problems and potential. Prev Med. 1986;15:537-48. CrossrefMedlineGoogle Scholar29. HaefnerBeckerJanzRutt DMNW. Impact of a negative breast biopsy on subsequent breast self-examination practice. Patient Educ Couns. 1989;14:137-46. CrossrefGoogle Scholar30. Patriarca P. Pneumococcal vaccination practices among private physicians. Public Health Rep. 1982;97:406-8. MedlineGoogle Scholar31. DismukeMiller SS. Why not share the secrets of good health? The physician's role in health promotion. JAMA. 1983;249:3181-3. CrossrefMedlineGoogle Scholar32. Becker M. The cholesterol saga: whither health promotion? Ann Intern Med. 1987;106:623-5. LinkGoogle Scholar33. RommFletcherHulka FSB. Prevention in clinical practice: problems and challenges. Arch Intern Med. 1981 ;141:1418. CrossrefMedlineGoogle Scholar34. MaheuxPineaultBeland BRF. Factors influencing physicians' orientation toward prevention. Am J Prev Med. 1987;3:12-8. CrossrefMedlineGoogle Scholar35. RosenLogsdonDemak MDM. Prevention and health promotion in primary care. Prev Med. 1984;13:535-48. CrossrefMedlineGoogle Scholar36. McClellan W. The physician and patient education: a review. Patient Educ Couns. 1986;8:151-63. CrossrefMedlineGoogle Scholar37. AvornSoumerai JS. Improving drug therapy decisions through educational outreach. N Engl J Med. 1983;308:1457-63. CrossrefMedlineGoogle Scholar38. EvansHaynesBirkett CRN. Does a mailed continuing education program improve physician performance? Results of a randomized trial in antihypertensive care. JAMA. 1986;255:501-4. CrossrefMedlineGoogle Scholar39. MaimanBeckerLiptak LMG. Improving pediatricians' compliance-enhancing practices. Am J Dis Child. 1988;142:773-9. CrossrefMedlineGoogle Scholar40. GreenEriksenSchor LME. Preventive practices by physicians: behavioral determinants and potential interventions. Am J Prev Med. 1988;4(Suppl): 101-7. MedlineGoogle Scholar41. LomasAndersonDomnick-PierreVaydaEnkinHannah JGKEMW. Do practice guidelines guide practice? The effect of a consensus statement on the practice of physicians. N Engl J Med. 1989;321:1306-11. CrossrefMedlineGoogle Scholar42. InuiYourteeWilliamson TEJ. Improved outcomes in hypertension after physician tutorials. Ann Intern Med. 1976;84:646-51. LinkGoogle Scholar43. PattersonFriedNagle JRJ. Impact of a comprehensive health promotion curriculum on physician behavior and attitudes. Am J Prev Med. 1989;5:44-9. CrossrefMedlineGoogle Scholar44. CohenLittenbergWetzelNeuhauser DBCD. Improving physician compliance with preventive medicine guidelines. Med Care. 1982;20:1040-5. CrossrefMedlineGoogle Scholar45. CheneyRamsdell CJ. Effect of medical records' checklists on implementation of periodic health measures. Am J Med. 1987;83:129-36. CrossrefMedlineGoogle Scholar46. McDonaldWilsonMcCabe CGG. Physician response to computer reminders. JAMA. 1980;244:1579-81. CrossrefMedlineGoogle Scholar47. KnightO'MalleyFletcher BMS. Physician acceptance of a computerized health maintenance prompting program. Am J Prev Med. 1987;3:19-24. CrossrefMedlineGoogle Scholar48. TierneyHuiMcDonald WSC. Delayed feedback of physician performance versus immediate reminders to perform preventive care. Med Care. 1986;24:659-66. CrossrefMedlineGoogle Scholar49. BeckerGomezKaiser DED. Improving preventive care at a medical clinic: how can the patient help? Am J Prev Med. 1989;5:353-9. CrossrefMedlineGoogle Scholar50. Roter D. Patient participation in the patient-provider interaction: the effects of patient question asking on the quality of interaction, satisfaction, and compliance. Health Educ Monogr. 1977;5:281-315. CrossrefMedlineGoogle Scholar51. SteeleBlackwellGutmannJackson DBMT. Beyond advocacy: a review of the active patient concept. Patient Educ Couns. 1987;10:3-23. CrossrefMedlineGoogle Scholar52. SchroederMyersMcPhee SLS. The failure of physician education as a cost containment strategy: report of a prospective controlled trial at a university hospital. JAMA. 1984;252:225-30. CrossrefMedlineGoogle Scholar53. AvornSoumerai JS. Use of computer-based Medicaid drug data to analyze and correct inappropriate medication use. J Med Syst. 1982;6:377. CrossrefMedlineGoogle Scholar54. WinickoffColtinMorganBuxbaumBarnett RKMRG. Improving physician performance through peer comparison feedback. Med Care. 1984;22:527-34. CrossrefMedlineGoogle Scholar55. EwartLiCoates CVT. Increasing physicians' antismoking influence by applying an inexpensive feedback technique. J Med Educ. 1983;58:468-73. MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: The University of Michigan School of Public Health Ann Arbor, MI 48109-2029 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByPhysician Counseling of Overweight Patients About Preventive Health BehaviorsBarriers in the Implementation of a Physical Activity Intervention in Primary Care SettingsPerspectives of Family Physicians on Computer-assisted Health-risk AssessmentsEducating physician assistants as agents in cancer control: Issues and opportunitiesCervical Cancer: The Indian PerspectiveEffectiveness of Individually Tailored Calendars in Promoting Childhood Immunization in Urban Public Health CentersThe News on Health Behavior: Coverage of Diet, Activity, and Tobacco in Local NewspapersStrengthening Asthma Education to Enhance Disease ControlClinical Preventive Medicine in Primary Care: Background and Practice: 1. Rationale and Current Preventive PracticesAn exploratory study of nursing and medical students health promotion counselling self-efficacyPhysician Recommendations for Diet and Physical Activity:An adolescent tobacco-use prevention trial in orthodontic offices.A Survey of Recreational Sun Exposure of Residents of San Diego, CaliforniaPatient Report of HIV Risk Screening by Primary Care PhysiciansImproving residents’ confidence in using psychosocial skillsPhysician Advice to Reduce Chronic Disease Risk FactorsAn analysis of learning experiences contributing to medical students’ self‐efficacy in conducting patient education for health promotionTesting a Model of Mammography Intention1Processing narratives of self-destructive behavior in routine medical encounters: Health promotion, disease prevention, and the discourse of health careSociety of General Internal Medicine SymposiumStrategies to increase preventive care in general practicePreventive Care Guidelines: 1991Robert S. A. Hayward, MD, Earl P. Steinberg, MD, MPP, Daniel E. Ford, MD, MPH, Michael F. Roizen, MD, Keith W. Roach, MD 15 September 1990Volume 113, Issue 6Page: 419-422KeywordsHealth information technologyHealth promotionHealth surveysMedical risk factorsMotivation Issue Published: 15 September 1990 PDF DownloadLoading ...
No takes yet. Share an insight, caveat, or question.
Marshall H. Becker (1990) studied this question.
Synapse has enriched 10 related papers. Consider them for comparative context: